A University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ physician is working to change how a common but often overlooked gynecologic condition is diagnosed and treated.

Kimberly Kho, who holds the nation’s first professorship in advanced gynecological surgery in the (JABSOM), recently authored a clinical expert series review on adenomyosis in . The publication places Kho among a select group of internationally recognized experts in women’s health.

“These articles are meant to synthesize the existing medical literature and turn it into meaningful clinical guidance,” Kho said. “The goal is that a physician could read it, deepen their understanding of the disease, and immediately apply what they learned in their practice on Monday morning.”

Adenomyosis occurs when tissue similar to the lining of the uterus grows into the uterine muscle, causing severe menstrual bleeding, chronic pelvic pain and fertility challenges. Despite affecting roughly one in three women, the condition remains underdiagnosed and under-researched.

“It’s astonishing how common it is,” Kho said. “But if you look at the research funding for adenomyosis, which then correlates to our scientific understanding of the disease and specific therapies, it’s just a drop in the proverbial bucket compared to how much and how many this disease impacts.”

Advances in diagnosis, care

Kho’s review provides a practical roadmap for OB–GYN physicians, covering disease mechanisms, diagnostic advances and modern treatment options. A major shift highlighted is the move toward noninvasive diagnosis using imaging tools such as ultrasound and MRI, rather than relying on hysterectomy for confirmation.

“Our paradigm for diagnosing has really evolved because our technologies have evolved. This allows us to name the condition and start treating it, rather than the alternative, which was often to write off the symptoms,” Kho said.

The review also challenges the idea that hysterectomy is the only effective treatment.

“There are many excellent uterine-preserving options,” Kho said. “Medical, interventional and surgical treatments can manage symptoms while preserving uterine function and future fertility.”

Kho hopes the publication will help establish clearer guidance for physicians worldwide while expanding access to advanced gynecologic care in Hawaiʻi.

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Cheers, hugs and tears flowed at the University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ (JABSOM) as the Class of 2026 opened envelopes revealing the next step in their medical journeys.

On March 20, 78 students participated in Match Day, learning where they will continue their training in residency programs across the country.

This year’s class is strongly committed to primary care, with 56% matching into internal medicine, family medicine, pediatrics and OB-GYN—fields that remain in high demand across Hawaiʻi. Additionally, 33% of graduates will remain in Hawaiʻi for residency.

Staying home to serve Hawaiʻi

For many students, staying home made Match Day especially meaningful.

“As cheesy as it might sound, I think it means the world to me,” said Kerrick Chinen. “I grew up in this place, these people have raised me, and it’s an absolute honor to be back serving the people and practicing even more at home.”

He added, “The heart said I really wanted to stay at home, but I knew the reality of it. It was a little dicey. So it was an absolute relief opening that envelope up and seeing the University of Hawaiʻi.”

Jonathan Carino shared a similar goal. “That’s always been my intention,” Carino said. “To do residency somewhere not in Hawaiʻi didn’t sit right with me, and I’m really glad I’m staying home here at ÌÇÐÄÊÓƵ.”

JABSOM Dean Sam Shomaker said that commitment reflects the school’s mission to serve the state’s most pressing health care needs.

“Primary care is the backbone of a healthy community, and Hawaiʻi continues to face a critical need in these areas,” Shomaker said. “We are proud to see so many of our students choosing this path and staying true to our mission of training physicians who will serve our communities here at home.”

It was also a notable year for surgery, with 19% of the class matching into surgical specialties.

Nationally, more than 38,000 medical students matched into residency programs this year, marking the largest Match in the history of the National Resident Matching Program.

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The nation’s first professorship in advanced gynecological surgery at a major academic institution was established last year at the (JABSOM) at the University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹, expanding access to specialized care in Hawaiʻi.

Just months after arriving, Kimberly Kho is already advancing that effort. Kho joined JABSOM after building one of the nation’s leading programs in minimally invasive gynecologic surgery at the University of Texas Southwestern Medical Center. Her work focuses on treating benign gynecologic diseases—noncancerous conditions that affect millions of women but can still be life-altering.

She is also helping train OBGYN residents in the diagnosis and treatment of conditions such as chronic pelvic pain, fibroids and endometriosis.

“These are benign diseases, meaning they’re not cancer,” Kho said. “But they can be completely debilitating.”

Addressing a critical gap in care

Conditions such as uterine fibroids and endometriosis are common and often severe. Fibroids affect an estimated 70 to 80% of women with a uterus, while endometriosis impacts about one in nine women.

For many patients in Hawaiʻi, access to specialized treatment has historically been limited, with some traveling to the mainland for advanced care.

“People were leaving the state to seek this kind of care or being presented with treatment options that didn’t honor their values, including more radical surgeries that would lead to loss of fertility,” Kho said. “Now we’re building the ability to provide those advanced, complex services here.”

Kho, who brings nearly two decades of experience, is working to build a multidisciplinary program that improves collaboration and expands awareness of these often misunderstood conditions.

“We have to educate our community, our patients and other healthcare providers,” she said.

Kho said Hawaiʻi already has the talent and expertise needed to support this work.

“What’s amazing is that the skill sets are already here,” she said. “The radiologists, pain specialists, physical therapists, they are all here. They just needed someone to help organize and bring those teams under the umbrella of multidisciplinary care together.”

A pioneer in obstetrics and gynecology (OBGYN) who strengthened women’s health education in Hawaiʻi is being honored with a new endowed professorship at the University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹â€™s (JABSOM).

Established through a gift from ÌÇÐÄÊÓƵ ²ÑÄå²Ô´Ç²¹ Professor of Law Emeritus Linda Krieger in honor of her father, John Krieger, the professorship recognizes his lasting impact on OBGYN training in the state in the 1960s.

John Krieger moved to Hawaiʻi in 1963, when the state faced a shortage of OBGYNs. Although already in practice, he returned to residency training to meet local licensing requirements.

“My father had been in practice for about six or seven years, but you couldn’t get a medical license here for a year if you moved here, so he went back to being a resident,” said Linda Krieger, a nationally respected law scholar and civil rights advocate. “That experience got him very interested in working on medical education, especially at the residency level.”

Krieger helped build OBGYN residency education at what was called The Queen’s Hospital at the time and later led residency training when JABSOM expanded to a four-year program.

“This was their whole life,” Linda said of her parents’ connection to Hawaiʻi. “My father really loved the multiculturalism here and the diversity of people and cultures. He felt very committed to that kind of community.”

First recipient carries legacy forward

The inaugural John A. Krieger Endowed Professorship was awarded to Lynne Saito-Tom, professor in the Department of OBGYN and Women’s Health at JABSOM. To Saito-Tom, the honor reflects her family’s deep commitment to education.

Her grandparents were unable to attend school beyond elementary level but believed strongly in higher education, ensuring their children went to college. Growing up in Wahiawā, her parents sacrificed daily—waking before sunrise and commuting long hours—so she could pursue her goals.

“Thanks to their sacrifices, I was able to pursue my educational goals of becoming a physician, the first in my family,” Saito-Tom said.

She added, “Dr. John Krieger, the first resident program director of our department, developed a strong curriculum for residency training, and I plan to utilize this endowment to advance medical education, including creating innovative curriculum, supporting trainees and enhancing faculty development.”

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From China to Hawaiʻi, Hongwen (Winnie) Wu has turned a career as a board-certified obstetrician-gynecologist (OB-GYN) into groundbreaking reproductive biology research. This fall, she earned her PhD in the Developmental and Reproductive Biology graduate program at the at the University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹, becoming the first Kosasa Graduate Student Assistantship recipient.

The prestigious assistantship, funded by Thomas Kosasa of Pacific IVF and a professor emeritus at JABSOM, was created to strengthen connections between the (YIBR), the OB-GYN Department, and Pacific IVF.

“Through a dynamic approach, I aspire to significantly contribute to improving individual patient health and advancing the broader landscape of women’s health research,” said Wu, who joined JABSOM’s Developmental and Reproductive Biology program from China in fall 2019.

Advancing fertility research and education

As a PhD student, Wu carried out her research in Steve Ward’s lab at YIBR, focusing on female fertility. She studied the protein EXOC5 in ovarian aging and discovered it is essential for normal egg development, with its absence leading to ovarian failure.

During her time at JABSOM, Wu co-authored five manuscripts and presented her work at seven local and four national conferences, including the Society for the Study of Reproduction and the Society for Reproductive Investigations. She received the 2024 ARCS Award in Medicine, served as a teaching assistant, volunteered at research events, and was a visiting scholar at Northwestern University.

Her long-term goal is to remain in Hawaiʻi as a research physician/scientist, blending cutting-edge research with clinical expertise to advance women’s healthcare.

“Winnie’s performance as the first Kosasa Assistantship-supported DRB student has been exemplary,” said Monika Ward, interim director of YIBR. “She contributed research of relevance to all four parties: DRB, YIBR, OB-GYN and Pacific IVF.”

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Native Hawaiian scientist Alika Maunakea of the University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ (JABSOM) has spent more than 20 years studying epigenetics–—how environment shapes health across generations. With colleague Monika Ward of JABSOM and the , they examined how maternal obesity before pregnancy may influence autism risk.

Related ÌÇÐÄÊÓƵ News story: ÌÇÐÄÊÓƵ study links maternal obesity to autism-like traits in offspring

Q: What motivated this research, and what did you discover?

We were struck by the worldwide rise in autism and by data showing that mothers who are obese face a 50–60% higher risk of having a child with autism. What wasn’t clear was when that risk takes hold—is it during pregnancy or even before? In our study, we found that maternal obesity before conception was enough to increase the likelihood of autism-related traits in offspring, at least in our mouse model. That finding points to an important window of time that hasn’t received much attention.

Q: How confident are you that these findings translate to humans?

While our work was done in mice, many of the same genetic pathways we studied are conserved in humans. What’s striking is that autism-related genes known to raise risk in people were also affected in the mouse model, not by mutations but by epigenetic changes that altered gene expression. So while it’s not proof, it strongly suggests that similar mechanisms could be at play in humans, and that gives our findings real relevance.

Q: Does obesity guarantee autism risk for a child?

No, it’s important to stress that obesity is not a determining factor. In our study, even among mice with obese mothers, about 60% developed normally. What maternal obesity does is raise the risk, which is very different from guaranteeing an outcome. That nuance matters, because it shows there’s room to intervene and reduce risks rather than assuming outcomes are fixed.

Q: What does this mean for timing—before vs, during pregnancy?

We’ve long known pregnancy is a critical period, but our study highlights that the preconception window is just as important. Health status before pregnancy can shape risks for children, not just for autism but also for other chronic conditions. This means lifestyle changes made even before planning a pregnancy, such as improving diet, exercise and overall metabolic health, may help improve outcomes for both parent and child.

Q: Is it ever too late to make lifestyle changes?

No. The message is that any step to improve health is worthwhile. Even outside the context of pregnancy, better diet and exercise lower risks for chronic disease. But when we’re talking about planning a family, those same changes may also lower risks for future children. So the preconception period is a powerful window of opportunity, but positive changes at any stage are valuable.

Q: Where does the research go from here?

The next step is to see whether improving health before conception can actually lower the autism risk we observed, and whether those benefits extend across multiple generations. We also found that male offspring were more affected than females, so we want to explore why that is and how long these effects last. These are unanswered questions with big implications for human health.

Q: How should the public understand this research?

Most importantly, this isn’t about blame. Obesity is shaped by many factors, like access to healthy foods, safe places to exercise, and healthcare resources. Our work shows opportunities where supportive policies, healthcare guidance, and community programs can make a difference. Beyond autism, improving metabolic health before conception is simply good practice for lifelong health, both for parents and for their children.

Q: How does Native Hawaiian knowledge influence your work?

As a Native Hawaiian epigeneticist, I draw inspiration from our ʻike kupuna (ancestral knowledge). For centuries, Hawaiians understood that pregnancy timing and environment shape a child’s health. For example, a saying advises strengthening the unborn child through diet and herbal remedies, an early recognition that what mothers do before and during pregnancy can affect future generations. Our research in epigenetics reflects that same idea: the environment can influence health outcomes long before birth.

A new University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ (JABSOM) endowment for a professorship dedicated to advancing benign gynecological surgery will enhance the Department of Obstetrics, Gynecology, and Women’s Health (OBGYN). The OBGYN department now holds the largest endowment among all JABSOM departments.

Benign gynecological conditions, such as uterine fibroids, endometriosis and ovarian cysts, affect many women and can cause significant pain and stress. The Advanced GYN Surgery Professorship will support a faculty member who will elevate training for OBGYN residents in areas like chronic pelvic pain, fibroids and endometriosis.

“Our department has long been recognized for excellence in gynecologic oncology and urogynecology, yet there has been a significant gap in dedicated expertise for advanced and complex benign gynecologic surgery,” said Ivica Zalud, OBGYN department chair. “The need for highly specialized faculty—at the full professor level, with fellowship training, board certification, and national recognition—is critical in ensuring that our learners receive the highest standard of clinical training in surgical care.”

“This endowment is a step towards filling a major void in Hawaiʻi’s health care system,” said JABSOM Dean Sam Shomaker. “Having a nationally recognized expert in this area, right in our backyard, will improve clinical care and give OBGYN residents the training they need to help Hawaiʻi’s women as they go into practice in our community.”

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A University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ faculty member’s personal interest in channel swimming has led to highlighting the rare interactions between cookiecutter sharks (Isistius brasiliensis) and humans, particularly among channel swimmers in Hawaiʻi. The study, led by Steven Minaglia, an associate professor of obstetrics and gynecology and women’s health at the University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ and an avid channel swimmer, showed how environmental conditions can increase the likelihood of these attacks.

Cookiecutter sharks, known for their distinctive feeding method that leaves cookie-cutter-shaped wounds, are typically found in deep tropical and subtropical waters. Despite their small size, these sharks can pose a significant threat, although rarely. Of the seven reported cookiecutter shark attacks on humans worldwide, six occurred in Hawaiʻi, and five of those involved channel swimmers.

Finding the link

Minaglia’s study analyzed data from 1961 to 2023, covering 129 successful solo channel swims and five shark-related injuries. He discovered a link between these attacks and environmental conditions, particularly on moonless nights. The risk of shark attacks significantly increases during complete darkness compared to when the moon or sun is visible. Other factors, such as swim start times and the time of year, also correlate with the likelihood of an attack.

Minaglia’s study was prompted by his ongoing personal research on channel crossings in Hawaiʻi to determine optimal swimming conditions. He planned to swim the 26-mile Kaʻiwi Channel between Oʻahu and Molokaʻi in 2020, but was concerned because of a series of shark attacks among swimmers the previous year.

“When I noticed that five out of six shark bites occurred on moonless nights, I felt a duty to publish these important findings that can potentially improve safety for channel swimmers,” said Minaglia, who successfully swam the challenging Kaʻiwi Channel in 22-hours in October 2020 during a full moon. He noted the strong currents during full moons also made it a difficult swim.

Minaglia compiled an electronic database in 2018 with data from the . His research is one of only three papers addressing cookiecutter shark attacks on live humans.

The study, supported by Queen’s University Medical Group where Minaglia serves as director of urogynecology and reconstructive pelvic surgery, is available as open access on .

“I hope this research provides valuable insights into safe swimming practices for the global swimming community,” Minaglia said.

A placenta (commonly known as the “afterbirth” or “ʻiewe” in Hawaiian) is a temporary organ which connects the mother to the fetus via the umbilical cord. Its purpose is to deliver nutrients and oxygen to the fetus while serving as a barrier to prevent infections or viruses from entering the developing fetus.

A new study by researchers at the (JABSOM) at the University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ and examined placentas donated by women who delivered in Hawaiʻi from 2006 to 2021, and found the presence of microplastic particles in the placenta.

Microplastics are visible to the naked eye, and examples can range from the plastic beads once found in exfoliating soaps, to particles from disintegrating plastic bags, to bits of plastic found in microwavable containers which are then inadvertently consumed by humans.

“We were shocked that these little pieces of plastic were getting across the mom’s gut and landing in the placenta,” said Men Jean Lee, an obstetrician and researcher at JABSOM and Kapiʻolani Medical Center. Lee, Rodrigo Weingrill and Johann Urschitz from ÌÇÐÄÊÓƵ ²ÑÄå²Ô´Ç²¹’²õ co-authored the research recently published in .

The researchers collected and studied 10 placentas in 2006, 2013 and 2021 and found the presence of microplastics grew each year.

• In 2006, 6 of the 10 placentas contained microplastics.
• In 2013, microplastics were found in 9 of the 10 placentas.
• In 2021, researchers found microplastics in all 10 placentas.

“We believe that the plastics may be floating around in food or being inhaled. It’s coming through our digestive fluids or lungs, and the particles are getting absorbed through the gut and traveling through the bloodstream, and then somehow collecting in the placenta during pregnancy,” Lee said. “The big question is, as it’s traveling through the placenta, can it get through the umbilical cord and then to the baby? We don’t know that right now.”

Link to global plastic production

We know that the rise in microplastics found in the placentas of Hawaiʻi mothers corresponds with the skyrocketing levels of global plastic production.

According to the Journal of Hazardous Materials, more than 6,000 megatons of plastic were produced in 2020. Less than 2,000 megatons were produced in 2000.

The big question is, as it’s traveling through the placenta, can it get through the umbilical cord and then to the baby?
—Men Jean Lee

Lee believes HHawaiʻi‘s remote location creates an added dependency on plastic.

“We’re the world’s most remote population center or island chain. We’re 2,300 miles from California and 4,000 miles from Japan,” Lee said. “For daily conveniences, we commonly use plastic wrap, plastic containers, plastic bags and single use water bottles.”

She suggests Hawaiʻi‘s location in the center of the Pacific Ocean, tropical climate, and lack of recycling centers can exacerbate how these plastics are disintegrating or breaking down.

“The incineration of garbage, landfills and marine pollution affect our communities. When trash is being burned, dust particles are released, and can spread into the air we breathe,” Lee said. “In fact, we are concerned about how the debris from the recent Lahaina fires may contain microplastics and other chemical toxins in the remains of the fires. Meanwhile, we already know that sunlight, heat and salt can speed up the breakdown of these everyday plastics. I’ve noticed plastic bags, even shoes, wear out quickly in Hawaiʻi and turn to dust. I never experienced this when I was living back in New York.”

Can microplastics enter the fetus too?

Lee and the JABSOM researchers will continue their research, now focused on seeing if the microplastics can pierce the protection of the placenta and enter the fetus before birth.

“We’re not trying to scare people,” Lee said, but acknowledges there are other questions that still need to be answered. “What are the sources of maternal microplastics? What are the plastics doing in the mother’s body and the placenta? Are they benign, or are they crossing over to the fetal side into the umbilical cord that is connected to the baby? If they are getting to the other side, are they affecting fetal growth and what happens to the baby when he/she grows up?”

A maternal-fetal medicine fellow at the University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ (JABSOM) brings focus to discriminatory regulations on postpartum sterilization for Medicaid recipients, particularly women from low-income backgrounds. Melanie Maykin’s was published in a November 10 issue of The Lancet Regional Health—Americas. The manuscript also led to Hawaiʻi Senate Concurrent Resolution 191 (SCR191), Urging the United States Department of Health and Human Services to amend its policies relating to postpartum sterilization waiting periods for Medicaid recipients.

“We’re excited to bring awareness to this issue, especially as we reflect on systemic discrimination and inequities within our healthcare system. Still, there is much more work to do,” said Maykin, who is with JABSOM’s Department of Obstetrics, Gynecology and Women’s Health.

Postpartum sterilization, a permanent form of birth control, is a procedure performed prior to a woman’s release from the hospital. Under the existing Medicaid insurance regulations, women must complete the mandated Medicaid Title XIX form at least 30 days in advance of the procedure or risk being denied or personally billed for the procedure. This rule does not apply to those who have commercial insurance. However, publicly insured (Medicaid) women who would appreciate the convenience, the economy and the autonomy in planning the size of their family with this procedure, are faced with existing barriers.

State legislation introduced

Maykin’s manuscript received the attention of Hawaiʻi State Sen. Chris Lee, who was inspired to write SCR191, which passed committees in the Hawaiʻi House and Senate during the 2021 Legislature. The measure seeks to abolish the time factor that has become obstructive to low-income women and their families.

“This [federal] legislation, which was initially implemented to protect individuals from reproductive coercion, ultimately created barriers to equal access specifically for low-income people,” Maykin said. “It’s an important reminder that when creating legislation or attempting to repair the harm we’ve caused with existing policy, we must intentionally center the voices of affected communities.”

According to Lee, SCR191 puts the state of Hawaiʻi on record as objecting to the Medicaid requirement. The resolution was also sent to Hawaiʻi‘s Congressional delegation, and federal department agencies.

“As far as I know, this is the first time a state has come out against this inequitable practice,” Lee said. “There are individuals and organizations pushing against this, but Hawaiʻi is the first state.”

Supporting testimonies at the Hawaiʻi Legislature were presented by the Hawaiʻi Section of the American College of Obstetricians and Gynecologists, among whom were OB-GYN practitioners, fellows and JABSOM faculty.

Maykin said that providing informed consent 30 days prior to birth, which is already a very unpredictable event, assumes that patients have the privilege of continuity in healthcare to see the same provider or group who knows them well.

“Moreover, this system depends on reliable transmission of the consent form to labor and delivery units. That is just not the reality for many low-income patients,” Maykin said.

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The University of Hawaiʻi and have established an academic affiliation agreement to formalize their collaborative efforts around medical education and training, research, clinical services and patient care with the ultimate goal of addressing the health care needs of the state of Hawaiʻi. The agreement is a three-party affiliation agreement between Hawaiʻi Pacific Health, the ÌÇÐÄÊÓƵ ²ÑÄå²Ô´Ç²¹ (JABSOM) and University Health Partners of Hawaiʻi (ÌÇÐÄÊÓƵP), JABSOM’s faculty practice group.

Areas of focus outlined within the agreement that will benefit patients and the state include:

• Creating synergies and aligning workforces to enhance models of care, strengthen academic programs and further each organization’s mission.
• Collaboration on health care education at Hawaiʻi Pacific Health medical centers and clinical sites continuing to provide education and training opportunities for residents, medical students, and other university learners.
• Enhanced support of research and other scholarly activities in Hawaiʻi that advance medical knowledge and health sciences.
• Strengthening partnership efforts on programs and activities that support the next generation of physicians and health care providers for Hawaiʻi.
• Coordination of clinical services and physician engagement in programs designed to improve health care for the residents of Hawaiʻi.

“Our hospitals have served as education and training sites for the University of Hawaiʻi and the John A. Burns School of Medicine for years, and we are proud to formalize this partnership and further enhance our collaborative efforts,” said Ray Vara, president and CEO of Hawaiʻi Pacific Health. “The COVID-19 pandemic has shined a spotlight on how essential it is for ±á²¹·É²¹¾±ʻ¾±â€™s residents to have access to quality health care, and our partnership with the University of Hawaiʻi will help us improve the health of our communities and work toward eliminating the disparities and inequities that exist today.”

“The University of Hawaiʻi and the John A. Burns School of Medicine have partnered with Hawaiʻi Pacific Health on many levels to advance medical education and training to support Hawaiʻi’s future health care needs,” said ÌÇÐÄÊÓƵ President David Lassner. “This new enhanced agreement reinforces our joint commitment to support medical education beginning with medical school through residency and fellowship training.”

As part of the agreement, JABSOM faculty who provide patient care as ÌÇÐÄÊÓƵP physicians in the areas of family medicine and obstetrics and gynecology will be integrated into the Hawaiʻi Pacific Health Medical Group (HPHMG), Hawaiʻi Pacific Health’s employed physician and advanced practice provider group.

“In order to truly create a healthier Hawaiʻi, we must support the growth and development of the next generation of health care providers for the state,” said Leslie Chun, HPHMG CEO. “This enhanced partnership with the university and the medical school enables us to ensure high-quality care will continue to be available for our patients in the years ahead, particularly in the areas of family medicine and obstetrics and gynecology, which are areas for which the state has a critical need for more physicians.”

These ÌÇÐÄÊÓƵP clinical providers will join other HPHMG employed academic clinicians with JABSOM faculty appointments in pediatrics and other disciplines. Medical education, research and training activities at Hawaiʻi Pacific Health facilities, including Kapiʻolani Medical Center for Women & Children (OB–GYN) and Pali Momi Medical Center (family medicine), are poised to advance in a highly synergistic manner. JABSOM will continue to oversee the academic activities of the faculty, and ÌÇÐÄÊÓƵP will help sustain support of JABSOM’s teaching and research mission.

“Through this opportunity to build synergy with Hawaiʻi Pacific Health, JABSOM becomes better positioned to educate and train our next generation of physicians,” said JABSOM Dean Jerris Hedges. “The academic affiliation agreement will focus on practice and training in pediatrics, family medicine and obstetrics & gynecology with Hawaiʻi Pacific Health. We look forward to many years of this mutually beneficial alliance, which will specifically align mission specific goals through strategic planning, operational collaborations and targeted fiscal commitments.”

• Related ÌÇÐÄÊÓƵ News story: ÌÇÐÄÊÓƵ, Queen’s Health Systems agreement expands medical education, research, July 28, 2021

Now, more than ever, the need for telehealth and telemedicine is crucial because of the COVID-19 pandemic. The University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ Maternal Telehealth Network for Maternal Fetal Medicine at the (JABSOM) was awarded $899,106 for internet connectivity and video conferencing services as well as electronic fetal monitoring devices and interfaces to allow for remote, essential women’s and prenatal health care.

This was just one of 62 applications from across the U.S. to the Federal Communications Commission (FCC) for funding commitments totaling $41.98 million for Round 2 of its COVID-19 Telehealth Program toward the purchase of equipment and hardware. The FCC program supports the efforts of healthcare providers to continue serving their patients by providing reimbursement for telecommunications services, information services and connected devices necessary to enable telehealth during the COVID-19 pandemic.

The award will allow physicians, the ÌÇÐÄÊÓƵ ²ÑÄå²Ô´Ç²¹ (PBTRC) and JABSOM to upgrade and expand capacity to treat their patients virtually, not only in the American Territories, but closer to home across the state of Hawaiʻi. The team of physicians is led by Men-Jean Lee, chief of maternal-fetal medicine in the Department of Obstetrics, Gynecology, and Women’s Health at JABSOM, a physician with University Health Partners, and the medical director of the Fetal Diagnostic Center at Kapiʻolani Medical Center for Women and Children.

“We were not successful last year to secure funding in Round 1 of the FCC COVID-19 Telehealth funding to provide maternal telehealth services in the state of Hawaiʻi since our numbers of COVID-positive patients were too low,” Lee said.

According to Lee, previous telehealth equipment funds were secured to provide maternal telehealth equipment to link JABSOM with American Samoa through a USDA Rural Health Development Grant for American Samoa, with the assistance from Christina Higa of the PBTRC, a consortium of health care experts experienced in telehealth networks services in Hawaiʻi and the U.S. Pacific Basin.

• Related ÌÇÐÄÊÓƵ News story: $667 boosts prenatal healthcare, telemedicine network for American Samoa, March 5, 2021

Supporting Hawaiʻi’s rural hospitals, health centers

Maternal telehealth consists of equipment that allows pregnant women in rural Hawaiʻi to have specialist consultations that include tele-ultrasound in their local communities, remote fetal monitoring to reassure pregnant woman and their providers that the fetus is healthy, and other innovative technologies that can provide increased access to healthcare providers without having to fly to Honolulu during a pandemic.

Lee added, “This latest grant gives us the opportunity to develop a maternal telehealth network across the State of Hawaiʻi. We are delighted to be using these funds to support our rural hospitals and Federally Qualified Health Centers on Oʻahu and the neighbor islands.”

The University of Hawaiʻi and The Queen’s Health Systems (Queen’s) announced a three-party affiliation agreement between ÌÇÐÄÊÓƵ ²ÑÄå²Ô´Ç²¹â€™s (JABSOM), Queen’s and University Health Partners of Hawaiʻi (ÌÇÐÄÊÓƵP). This affiliation agreement, expected to be operational by September, will expand medical education and research, engage the next generation of healthcare professionals and improve the health and well-being of the people of Hawaiʻi.

ÌÇÐÄÊÓƵ is currently working with another one of its valued healthcare partners, Hawaii Pacific Health, to develop a separate affiliation addressing the departments of Pediatrics, OB/GYN and Family Medicine.

The new affiliation agreement with Queenʻs will benefit patients and the community by:

• Strengthening and enhancing the education of the next generation of medical students, residents, fellows and other health professionals in Hawaiʻi.
• Attracting and retaining talented faculty, physicians and researchers in Hawaiʻi.
• Expanding clinical and research programs and providing opportunities to create innovative models of care.
• Enhancing teaching, research and community service missions.
• Encouraging and creating pathways for the next generation of healthcare professionals to provide care in our state.
• Improving each organization’s ability to meet the needs of vulnerable communities and address health inequities.
• Accelerating the achievement of improving the overall health of communities served.

A key component of this affiliation agreement is the creation of a combined physician group to be named The Queen’s University Medical Group (QUMG). This group of more than 450 providers, representing 17 specialties, will further strengthen high quality, compassionate care, innovation, research and education in Hawaiʻi.

As part of the QUMG, ÌÇÐÄÊÓƵ faculty will be employed and supported by Hawaiʻi’s largest clinical site for training medical students and more than 100 residents and fellows from JABSOM. Queen’s will ensure the medical group has the support needed to meet educational needs. JABSOM will oversee the academic activities of the faculty, and ÌÇÐÄÊÓƵP will help sustain support of JABSOM’s teaching and research mission.

“This opportunity to align the clinical care and academic roles of those working at Queen’s to enhance training of our learners will transform medical education and research at JABSOM. We look forward to working with Queen’s through this new affiliation to help support Hawaiʻi’s healthcare training and service needs for the future,” said Jerris Hedges, dean of JABSOM.

“By unifying our practices, we will strengthen the education and development of the next generation of caregivers in a culturally grounded way, infuse research and innovation into our delivery systems, and expand and improve key clinical programs,” said Jill Hoggard Green, CEO of The Queen’s Health Systems. “We look forward to enhancing our already strong and longstanding partnerships with the university to achieve our shared goal of improving the health of our communities, both now and in the future.”

Since 1995, the University of Hawaiʻi at ²ÑÄå²Ô´Ç²¹ John A. Burns School of Medicine Research Day and Awards has been a milestone moment for residents—and later on fellows—to present their research during their first few years as physicians. For the first time in its long history, the annual event was held virtually on its 25th anniversary.

Despite circumstances caused by COVID-19, the department still found a way to celebrate its residents and fellows. They were able to present their research via Zoom, while maintaining social distancing guidelines.

This year’s event was dedicated to obstetricians and gynecologists who are currently serving on the frontlines of the pandemic, providing essential health care in Hawaiʻi’shospitals, offices and community clinics.

For two and a half hours, residents and fellows took turns sharing their hypothesis driven research with faculty attendees and colleagues on a variety of topics, such as racial and ethnic disparities, abortion, diet quality, home births and contraceptive methods. Following their presentations, awards were presented in three categories: Most Outstanding, Audience Choice and the Santosh Sharma Audience Choice Awards.

“We appreciate that even in the midst of this global pandemic, we can come together as a community to discover, learn and inspire each other in our common goal of advancing women’s health in Hawaiʻi and beyond,” said professor and department chair Ivica Zalud.

Also assisting with the event were Associate Professor Reni Soon and Assistant Professor Shandhini Raidoo.

Research Day Awards

Most Outstanding Resident Research Award
Sharareh Firouzbakht
“Abortion Knowledge Affecting Abortion Provision after Obstetrics and Gynecology Residency”

Audience Choice Award
Christina Buchanan
“Neonatal Hypoxic Ischemic Encephalopathy and Planned Home Birth”

Santosh Sharma Audience Choice Award
Chief residents who already submitted their research for publication:

Nikki Kumura
“Pharmacy Access to Ulipristal Acetate in Small Cities Throughout the United States”

Jennifer Wong
“An Investigation on the Completeness of Salpingectomy Intended for Ovarian Cancer Risk Reduction”

Jennifer Chin
“Buffered Lidocaine for Paracervical Blocks in First Trimester Outpatient Surgical Abortions”

Caroline Lau
“Duration of Foley catheter cervical ripening as a predictor of total length of labor”

The University of Hawaiʻi at Mānoa has received a $5.3 million grant to continue research at the laboratory that became world-famous for producing mice and other animals that glow green under ultraviolet light. This grant will allow the John A. Burns School of Medicine (IBR) to produce transgenic mice for other researchers seeking medical cures at ÌÇÐÄÊÓƵ.

The mouse and its pups glowed green because jellyfish genes had been inserted into a mouse embryo to demonstrate the lab’s successful technique for inserting DNA from an unrelated organism into that of another animal. The first green mouse was born, and then she transferred the glowing gene to her pups.

“All along, we’ve been developing new technologies to make us even better,” said Steven Ward, IBR director. “With this grant, we’ll be able to build on our previous 10 years of research to provide genetically altered mice for anybody at ÌÇÐÄÊÓƵ. These are models that scientists can use for their research—mice with specific diseases or with a certain gene missing or with a gene present so the researchers can see what they can do with it.”

Since mice are the closest animals to humans for biological testing, Ward said, making better mouse models allows scientists to advance cures.

• Read more about the Institute for Biogenesis Research at ÌÇÐÄÊÓƵ News

This is the third consecutive five-year funding award the IBR has been selected to receive.

The federal funding from the National Institutes of Health’s National Institute of General Medical Sciences will support collaborations between IBR, part of the ÌÇÐÄÊÓƵ Mānoa , and its reproductive biology departments of and .

—By Tina Shelton

Scott Harvey, a University of Hawaiʻi medical school faculty member is working with the state and local lawmakers to reduce the number of women dying in Hawaiʻi during childbirth. Mothers in Hawaiʻi—and the United States as a whole—are dying of pregnancy-related complications, or maternal mortality, at higher rates than in any other developed country.

Over the past three decades, nations like Germany and Japan have significantly decreased maternal deaths, while the situation has worsened by 300 percent in the U.S. In Hawaiʻi, maternal deaths account for 5 to 15 fatalities every year.

In 2016, Hawaiʻi lawmakers mandated a comprehensive study of child and maternal deaths. Harvey, assistant professor and director of residential simulation at the (JABSOM) and the state’s only obstetric critical care specialist, chairs the Hawaiʻi Department of Health Maternal Mortality Review Committee.

Harvey, who earned his medical degree from JABSOM in 2010, said although there is no clear-cut explanation of why mothers in Hawaiʻi are dying in childbirth, he urged all women who are pregnant or planning pregnancy to seek care from a professional healthcare provider.

“The unfortunate thing is a lot of the maternal deaths that we’ve seen have had either very minimal or no prenatal care,” said Harvey. “Some (women) didn’t even know they were pregnant.”

The mortality review committee submitted its second annual report to the Legislature based on reviews conducted in 2017 and continues to meet twice a year to discuss strategies to prevent future maternal deaths.

See the .

, has been named 2017 Physician of the Year by the (HMA). Zalud is the chair of the at the University of Hawaiʻi .

Zalud will receive the honor on October 7 at the  at the Hilton Hawaiian Village.

Under Zalud’s leadership, several members of the department have invested their own assets to support the training of future specialists in women’s health. Gifts to OB-GYN have exceeded $8 million, including $6 million by Professor Emeritus , who has said the quality of care provided by doctors trained by the School of Medicine inspired him.

In September, Zalud will the first physician in Hawaiʻi to be named a fellow of the . He is also currently serving a four-year term as a vice president of the .

“OB-GYN is a department on the move—and moving all in the right direction,” said , dean of Medicine. “We couldn’t be more pleased that HMA is recognizing Dr. Zalud’s role as a Hawaiʻi healthcare leader.”

JABSOM OB-GYN plays a major role in health care statewide, because its faculty are involved in the deliveries of one third of the babies born in Hawaiʻi every year, many of them high risk births, and many born to families unable to pay for the service.

For full story, go to .

—By Tina Shelton

As “ground zero” in the state’s worsening physician shortage, there is a critical need for primary care physicians on the rural Big Island. The most recent Hawaiʻi Physician Workforce Assessment calculated that Hawaiʻi Island has 20 percent fewer doctors than it needs to serve its current population.

The University of Hawaiʻi at Mānoa’s John A. Burns School of Medicine’s has deployed a new faculty physician to serve patients in Hilo. becomes the first OB-GYN doctor in Hilo employed by (ÌÇÐÄÊÓƵP), the (JABSOM) faculty practice plan. Khozaim is an assistant clinical professor, who will help to train other physicians beginning next year.

Hilo Bay Clinic services underserved communities

The JABSOM OB-GYN residency program will begin regular clinical rotations on Hawaiʻi Island. In collaboration with the and , future doctors will have the opportunity to see what rural medicine can be like as they actually care for patients, under faculty supervision, in an underserved community. Khozaim hopes to inspire newly-trained physicians to provide services on Hilo or in other areas in need of medical services.

“A ÌÇÐÄÊÓƵ presence in the Big Island seems long overdue and I think everyone is optimistic about the positive impact ÌÇÐÄÊÓƵ can have on Hilo, and the Big Island in general,” he said. “This community definitely deserves our attention.”

“To people from outside of Hawaiʻi Island, I can never express what this means to us,” said Hawaiʻi County Mayor Harry Kim. “This is almost like a culmination of years and years of trying to get more medical resources here. And I can’t say enough how much of a breakthrough this is.”

Contact information: Bay Clinic’s Hilo Women’s Health Center located at 73 Puʻuhonu Place, Suite 204. (808) 333-3500

For more information on the clinic and Khozaim, .

—By Tina Shelton

Faculty of the (OB-GYN) at the (JABSOM) are involved in nearly a third of the births in Hawaiʻi each year. Many of these physicians practice medicine through the University Health Partners of Hawaiʻi, which is JABSOM’s faculty practice plan.

JABSOM University Health Partners of Hawaiʻi faculty made the largest philanthropic investment in JABSOM to date by faculty. Using its professional service collections, the team donated $500,000 to create an endowment.

On January 28, the ÌÇÐÄÊÓƵ Board of Regents approved the Endowed Professorship in the Department of Obstetrics, Gynecology and Women’s Health at JABSOM.

“The OB-GYN faculty decided to make a gift with their earnings and the University Health Partners of Hawaiʻi Board voted unanimously to support this endowment,” said Shared Chip Ellis, University Health Partners’ chief financial officer. “The creation of the Department of OB-GYN Professorship is an ideal collaboration between the department and the faculty practice plan. We know that this endowment will have great outcomes. It will help the department attract, support and retain talented faculty who will give back to Hawaiʻi immeasurably. The endowment will also provide critical resources for faculty development and enhance the research, education, and community outreach missions of the department.”

JABSOM Dean said, “This is a very important gift for us. It is a powerful demonstration of how deeply the OB-GYN faculty believe in and support their department. They know that by investing in themselves they can do more to serve Hawaiʻi’s families. A gift of this magnitude will help ensure the future success of the department.”

“ is proud of our partnership with the faculty of the John A. Burns School of Medicine, which enables us to provide the specialized maternity care that our hospital is recognized for,” said Kapiʻolani CEO Martha Smith. “This endowment demonstrates their commitment to the health of Hawaiʻi’s women and children, and we are very grateful for their continued support and collaboration in providing quality patient care.”

Donna Vuchinich, president and CEO of the , said “These gifts signal a growing recognition that private support is critical to ensuring long-term departmental success. We are most grateful to these important donors who are making such a difference for Hawaiʻi.”

—

University of Hawaiʻi medical students, residents and faculty from the are involved in the deliveries of one third of the babies born in Hawaiʻi every year, many of them high risk births.

Thanks to a $5 million dollar gift to the , the program will be able to invest in its clinical training, research and faculty development.

“This is a huge vote of confidence for what this department did in the past, what we’re doing now and what we want to do in the future for the state of Hawaiʻi and beyond, the Pacific Rim and even nationally,” said Dr. Ivica Zalud, chair of the Deparment of OB/GYN and Women’s Health.

The gift comes from the Kosasa family, who founded ABC Stores in 1964. It is the largest private philanthropic investment to date by an individual donor or family, to the university’s medical school. The gift is being given just as the medical school kicks off the 50th anniversary of its founding in 1965.

Dr. Thomas Kosasa represented the Kosasa family at an informal announcement to faculty and residents at , where he is professor emeritus in the Department of Obstetrics, Gynecology and Women’s Health.

Kosasa says part of the gift will create the $4 million Kosasa Endowed Chair for current department chair Zalud. The other $1 million will create two Kosasa Endowed professorships.

“I think the students will understand that what is given to you, you should give back. And I think that’s the most important thing is to give back. I’ve had a wonderful opportunity and education and I’d like to give that back to our medical school and to our students,” said Kosasa.

This isn’t the first gift from the Kosasa family—in 2000 the family invested in the start-up of the university’s .

“Now, 15 years later, we’ve created a whole new generation of scientists who are working on issues around maternal fetal medicine and helping families have children that might not otherwise have had the opportunity,” said Dr. Roy Magnusson, JABSOM associate dean for clinical affairs. “And so that kind of gift 15 years later keeps on giving and we hope to be really good stewards of this gift and to make sure it’s put to very good use.”